Pediatric Oncology and Hematology, University of Utah, Salt Lake City, Utah, USA.
Cancer Immunotherapy, Huntsman Cancer Institute, Salt Lake City, Utah, USA.
J Immunother Cancer. 2020 Dec;8(2). doi: 10.1136/jitc-2020-000653.
Ewing sarcoma (ES) is thought to arise from mesenchymal stem cells and is the second most common bone sarcoma in pediatric patients and young adults. Given the dismal overall outcomes and very intensive therapies used, there is an urgent need to explore and develop alternative treatment modalities including immunotherapies. In this article, we provide an overview of ES biology, features of ES tumor microenvironment (TME) and review various tumor-associated antigens that can be targeted with immune-based approaches including cancer vaccines, monoclonal antibodies, T cell receptor-transduced T cells, and chimeric antigen receptor T cells. We highlight key reasons for the limited efficacy of various immunotherapeutic approaches for the treatment of ES to date. These factors include absence of human leukocyte antigen class I molecules from the tumor tissue, lack of an ideal surface antigen, and immunosuppressive TME due to the presence of myeloid-derived suppressor cells, F2 fibrocytes, and M2-like macrophages. Lastly, we offer insights into strategies for novel therapeutics development in ES. These strategies include the development of gene-modified T cell receptor T cells against cancer-testis antigen such as XAGE-1, surface target discovery through detailed profiling of ES surface proteome, and combinatorial approaches. In summary, we provide state-of-the-art science in ES tumor immunology and immunotherapy, with rationale and recommendations for future therapeutics development.
尤因肉瘤(ES)被认为起源于间充质干细胞,是儿童和青年中第二常见的骨肉瘤。鉴于总体预后不良和使用的非常强化治疗,迫切需要探索和开发替代治疗方式,包括免疫疗法。在本文中,我们提供了 ES 生物学概述、ES 肿瘤微环境(TME)的特征,并回顾了可通过免疫为基础的方法靶向的各种肿瘤相关抗原,包括癌症疫苗、单克隆抗体、转导 T 细胞受体的 T 细胞和嵌合抗原受体 T 细胞。我们强调了迄今为止,各种免疫治疗方法治疗 ES 的疗效有限的关键原因。这些因素包括肿瘤组织中缺乏人类白细胞抗原 I 类分子、缺乏理想的表面抗原,以及由于髓源抑制细胞、F2 纤维母细胞和 M2 样巨噬细胞的存在而导致的免疫抑制性 TME。最后,我们提供了 ES 中新型治疗策略的见解。这些策略包括针对癌症睾丸抗原(如 XAGE-1)的基因修饰 T 细胞受体 T 细胞的开发、通过 ES 表面蛋白质组的详细分析发现表面靶标,以及联合方法。总之,我们提供了 ES 肿瘤免疫学和免疫疗法的最新科学,为未来的治疗发展提供了依据和建议。